DAN ROBERT BODISON JR. (NPI# 1215937610) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215937610 |
| Entity Type | Individual |
| Full Name | DAN ROBERT BODISON JR. |
| Credential | MD |
| Practice Address |
4605 Monticello Rd Eau Claire Cooperative Health Center Columbia SC 29203-4156 |
| Practice Telephone | 8032527001 |
| Practice Fax Number | 8032525219 |
| Mailing Telephone | 8032527001 |
| Mailing Fax Number | 8032525219 |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2011-06-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 19113 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 119134 | 05 |
| Street Address |
4605 MONTICELLO RD EAU CLAIRE COOPERATIVE HEALTH CENTER |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29203-4156 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215937784 | Stuart Arnim Hamilton | Pediatrics | 4605 Monticello Rd, Eau Claire Cooperative Health Center, Columbia, SC 29203-4156 | 2005-07-27 |
| 1558992701 | Milissa Pauling Davis | Nurse Practitioner | 4605 Monticello Rd, Columbia, SC 29203-4156 | 2020-01-27 |
| 1295127868 | Paul Potylicki | Counselor | 4605 Monticello Rd, Bldg B, Ste.1, Columbia, SC 29203-4156 | 2015-02-19 |
| 1497150262 | Ruth-narumi Amador | Counselor | 4605 Monticello Rd, Bldg B, Ste.1, Columbia, SC 29203-4156 | 2014-10-23 |
| 1467795815 | Eau Claire Cooperative Health Centers, Inc. | Clinic/Center | 4605 Monticello Rd, Bldgb, Ste.2, Columbia, SC 29203-4156 | 2013-04-04 |
| 1982951000 | Julie Lynn Brasher | Nurse Practitioner | 4605 Monticello Rd, Columbia, SC 29203-4156 | 2012-08-08 |
| 1700168028 | Donald R Sampson | Internal Medicine | 4605 Monticello Rd, Columbia, SC 29203-4156 | 2011-09-13 |
| 1720367170 | Tonna L Coleman | Physician Assistant | 4605 Monticello Rd, Columbia, SC 29203-4156 | 2011-08-16 |
| 1861798845 | Elizabeth Wagoner Knight | Nurse Practitioner | 4605 Monticello Rd, Columbia, SC 29203-4156 | 2011-02-08 |
| 1265745202 | Eau Claire Cooperative Health Center, Inc. | Clinic/Center | 4605 Monticello Rd, Bldg A, Ste.1, Columbia, SC 29203-4156 | 2010-07-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475284 | Matthew Leon Brigmon | Surgery | 2 Richland Medical Park, Suite 300, Columbia, SC 29203 | 2020-10-23 |
| 1730706839 | John James Gannon | Family Medicine | Prisma Health Medical Group Family Medicine, 3209 Colonial Drive, Columbia, SC 29203 | 2020-07-06 |
| 1790302362 | Klariz Teves Tucker | Internal Medicine | Internal Medcine Center, 1801 Sunset Drive, Columbia, SC 29203 | 2020-06-30 |
| 1811514482 | Esther Ruth Swan | Psychiatry & Neurology | Prisma Health General Psychiatry Center, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-30 |
| 1447877014 | Jordan Kaitlyn Merrels | Psychiatry & Neurology | Prisma Health Medical Group General Psychiatry, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-30 |
| 1306463187 | Jessica Leigh Watson | Psychiatry & Neurology | Prisma Health General Psychiatry, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-29 |
| 1053938852 | Garrison Glenn Rice | Family Medicine | Prisma Health Medical Group Family Medical Center, 3209 Colonial Drive, Columbia, SC 29203 | 2020-06-29 |
| 1053938977 | Rachel Ellen Harper | Obstetrics & Gynecology | The Womens Center, 1801 Sunset Drive, Columbia, SC 29203 | 2020-06-26 |
| 1609493592 | Elizabeth Marie Kern | Orthopaedic Surgery | Prisma Health Medical Group Orthopedic Center, 2 Medical Park, Ste 105, Columbia, SC 29203 | 2020-06-26 |
| 1891312799 | Kathryn Victoria Steverson | Psychiatry & Neurology | Prisma Health Medical Group Psychiatry Center, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-26 |
| Find all providers in zip 29203 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972128742 | Emily Anne Cloessner | Pediatrics | Prisma Health Childrens Hospital Outpatient Center, 14 Medical Park, Ste 400, Columbia, SC 29203 | 2020-06-08 |
| 1043833890 | Lauren F. Cook | Pediatrics | Prisma Health Children's Hospital Outpatient Center, 14 Medical Park, Ste 400, Columbia, SC 29203 | 2020-05-27 |
| 1619598158 | Zeel Hiren Patel | Pediatrics | Childrens Hospital Outpatient Center, 14 Medical Park, Ste 400, Columbia, SC 29203 | 2020-05-06 |
| 1427695824 | Naseem Khan | Pediatrics | 10851 Clarksville Pike, Columbia, MD 21044-1338 | 2019-12-04 |
| 1164089124 | Mercy Clinic Illinois, LLC | Pediatrics | 1019 Valmeyer Rd, Columbia, IL 62236-4123 | 2019-05-24 |
| 1629568480 | Heather Kay Lynn | Pediatrics | Pediatric Outpatient Clinic, 1801 Sunset Drive, Columbia, SC 29203 | 2018-05-16 |
| 1174013932 | Dalton Mark Renick | Pediatrics | Pediattric Outpatient Center, 14 Medical Park, Ste 400, Columbia, SC 29203 | 2018-05-16 |
| 1033630330 | Brian Bradley Johnson | Pediatrics | Children's Hospital Outpatient Center, 14 Medical Park, Ste 400, Columbia, SC 29203 | 2017-06-28 |
| 1316350226 | Duncan Lee Norton | Pediatrics | 14 Medical Park, Ste 400, Children's Hospital Outpatient Center, Columbia, SC 29203 | 2014-06-09 |
| 1225440910 | Michael Mitchell | Pediatrics | 14 Medical Park Ste 400, Pediatric Clinic, Columbia, SC 29203 | 2014-05-29 |
| Find all providers in COLUMBIA | ||||
Please comment or provide details below to improve the information on DAN ROBERT BODISON JR..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.